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Summary - Cardiovascular pharmacology (PED2007)

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Summary of lecture notes containing detailed info: Anti hypertensives Heart failure Antiplateletes and anticoagulants Hyperlipidaemia Ischaemic heart disease Anti arrhythmithic

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  • July 30, 2023
  • 34
  • 2022/2023
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, ANTI HYPERTENSION 1-3
LECTURE



guidelines)
Hypertension (NICE
·
Hypertension:high blood pressure (bp)
2nd largest global risk factor for disease 30% of all strokes
-


·




and ischemic heart disease
·
Patient diagnosis:
1) Normotensive:120180mmH4

2) stage / hypertension:patient (80 yrs. With clinical by
(24n)
>
140190mmHg vs. ambulatory pp. 135/85MMHG

↳ can have organ damage. IV disease, renal disease, diabetes

3) stage 2 hypertension:patient of any age with clinical bp.

>160/100mmHg vs. ambulatory by.150/95mmHg

4) Resistant hypertension:pp. 140/90 mmHg after treatment

with at least 3 antihypertensive drugs
BD. 180/110:patient at risk-start antihypertensive drug
=
·




treatment without ambulatory by monitoring (ABPM) or home pp.

monitoring (HBPM)
·
cardiovascular risk factors:

1) Age+seX

2) Cholesterol/HDL ratIO

3) BD
4) SMOKING StatUS

5) Ethnicity:family history (CHD in 1st degree relative (60)

6) Deprivation (Townsend scores income, employment, housing
-




7) BM 1

8) Disease:diabetes, rheumatoid arthritis, chronic kidney disease,
atrial fibrilation (rapid irregular heartbeat)
·

Essential/primary hypertension:bp>140/90mmHg with no

identifiable cause -




develop gradually over many yrs. occurs after

early adulthood (prevalence 4 with ages
·Patients 140:high cardiac output with normal peripheral

resistance

older patients:normal/I cardiac outputwith a peripheral
resistance


secondary hypertension:high by caused by underlying condition
that tends to appear suddenly
x linked to:obstructive sleep apnoed. Kidney problems, advenal

gland tumours, thyroid problems, congenital defect of blood

vessels, medicines (birth control, cold, decongestant. OTC pain

relief, prescrip, arugs), cocaine, amphetamine
·

Lifestyle changes to control DD:
·


Eat healthy.I salt intake (<2300mg/day)
Healthy weight
↑ physical activity:1bp, stress, health problems

Limit alcohol:no smoking
control by during pregnancy
·
Treating high by may fail due to:

1) Lifestyle problems
2) COMD11Ance

3) White coat/masked hypertension
4) Drug-drug interactions (sympathomimetics + bp)
3) volume overload:No "intale:renal problems

6) unsuspected secondary cause:renal/endocrine disease



RAAS system

sympathetic nerves
ctions
A of Angiotensin II that 4 bp:
1) Stir. advenal cortexto release aldo.

2) Release of ADH from pithatary which 4

(inactives water reabsorption in kidney:4 D.D.
4
(actives 3) Stimulates thirst
I
4) causes vasoconstriction:4 b.p.
5) cardiac,vascular hypertrophy-- muscle
mass:4 cardiac output

, ↑ athophysiologies of hypertension




Atherosclerosis:development of fatty plaques,cholesterol in
·




wall of arteries as part of inflammatory response - over yrs.

↳ laque gets bigger eventually causing vessel occlusion and

thrombus formation
·
other pathophysiologies:
1) Trouble with memory/understanding:due to uncontrolled

high up affecting ability to think, remember, learn
2) Dementia:narrowed/blocked arteries can limit blood flow to

brain):vascular demential or stroke that interrups blood to

brain

·
A abdominal
:




aorta

B c Kidney in artery
bulge
=
+




D:aortic aneurysm: clinical significance as may

rupture with massive blood,likely death
E F +


COMMON
=

iliac artery


Mechanisms controlling DD
BD CO resistance
-
=

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